[Implant augmentation in pelvic surgery. Options and technique]

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Biomaterials

Background:

• Osteoporotic pelvic fractures pose challenges in trauma surgery due to poor bone stock.
• Reduced implant anchorage necessitates solutions for stable fixation.
• Early patient mobilization is critical in geriatric populations to prevent complications.

Purpose of the Study:

• To evaluate implant augmentation as a method to improve implant anchorage and stability in osteoporotic bone.
• To discuss the application of implant augmentation in treating pelvic ring fractures.
• To highlight the safety considerations and advancements in implant augmentation for pelvic surgery.

Main Methods:

• Review of implant augmentation techniques for osteoporotic pelvic fractures.
• Description of cement augmentation for iliosacral screws and pedicle screws.
• Discussion of risks associated with polymethylmethacrylate (PMMA) cement, including leakage and heat generation.

Main Results:

• Implant augmentation can increase implant anchorage and stability in osteoporotic bone.
• Cement augmentation is utilized for sacral insufficiency fractures and lumbar/sacral pedicle screws.
• Potential complications include neurovascular compromise and cement embolism.

Conclusions:

• Implant augmentation requires careful indication due to specific procedural risks.
• Specialized implants, intraoperative navigation, and 3D imaging enhance patient safety.
• These advancements contribute to making implant augmentation a low-risk procedure.